Disturbed Sleep Pattern - NCP for Lower Back Pain

Nursing Care Plan for Lower Back Pain (LBP)


Low Back Pain is chronic pain in the lumbar, usually caused by a recessive the vertebral muscles, herniation and regeneration of the nucleus pulposus, osteoarthritis of the lumbar sacral spine (Brunner, 1999).

Causes

• Changes in posture usually because primary and secondary trauma. Primary trauma such as : Trauma spontaneously, for example accidents. Secondary trauma such as : HNP, osteoporosis, spondylitis, spinal stenosis, spondylitis, osteoarthritis.
• Lumbosacral ligament instability and muscle weakness.
• Procedures degeneration in elderly patients.
• The use of heels that are too high.
• Obesity.
• Lifting weights the wrong way.
• Sprain.
• Prolonged exposure to vibration.
• Gait.
• Smoking.
• Sitting too long.
• Less exercise (by sport).
• Depression / stress.
• Sports (golp, tennis, soccer).

Risk Factors of Low Back Pain

Physiological risk factors.

• Age ( 20-50 years ).
• Lack of physical exercise.
• Less anatomical postures.
• Obesity.
• Severe scoliosis.
• HNP.
• Spondylitis.
• Spinal stenosis (narrowing of the spine).
• Osteoporosis.
• Smoking.

Environment risk factors .

• Sitting too long.
• Prolonged exposure to vibration.
• Sprains or twisted.
• Sports ( golf, tennis, gymnastic, and football).
• Vibration old.

Psychosocial risk factors.

• Inconvenience of work.
• Depression.
• Stress.

Clinical Manifestations

Changes in gait.

• Walking stiff.
• No bias play back.
• Lame.

Innervation

• When tested with a light and a touch of the pin, the patient felt a sensation on both limbs, but having a stronger sensation in areas that are not stimulated.
• Uncontrolled defecation and urination.

Pain.

• Acute and chronic back pain for more than two months.
• Pain when walking with the heel.
• Pain in the muscles.
• Lower back pain gets spread legs.
• Painful heat on the back of the thigh or calf.
• Severe pain in the feet increases.

Nursing Care Plan for Lower Back Pain

Nursing Diagnosis : Disturbed Sleep Pattern related to pain, discomfort

Defining characteristics :

• Patients appear to endure pain ( moaning, grinning )
• Patients express can not sleep because of pain .

Goal : sleep needs can be met.

Outcomes :

Sleep

• The amount of time to sleep enough.
• Normal sleep patterns.
• Enough quality sleep.
• Sleep on a regular basis.
• Not often awakened.
• Vital signs within normal limits.

Rest

• Adequate rest.
• The quality of a good rest.
• Enough physical rest.
• Enough psychic rest.

Anxiety control

• Adequate sleep.
• There is no physical manifestation.
• No behavioral manifestations.
• Seeking information to reduce anxiety.
• Using relaxation techniques to reduce anxiety.
• Interact socially.

Interventions for Lower Back Pain

Improved sleep / Sleep Enhancement

1. Assess patterns of sleep / activity patterns.
2. Encourage clients to sleep on a regular basis.
3. Explain the importance of adequate sleep during illness and treatment.
4. Monitor sleep patterns and note the physical, psychosocial disrupt sleep.
5. Discuss on the client and family about the technical improvement of sleep patterns.

Environmental management

1. Limit visitors.
2. Take care of the noisy environment.
3. No nursing action when clients sleep.

Anxiety Reduction

1. Explain all procedures including the feelings that may be experienced while undergoing the procedure.
2. Give the object that can provide a sense of security.
3. Speaking slowly and calmly.
4. Build a trusting relationship.
5. Listen attentively clients.
6. Create an atmosphere of mutual trust.
7. Encourage parents to express feelings, perceptions and anxiety verbally.
8. Provide equipment / entertaining activities to reduce tension.
9. Suggest to use relaxation techniques.
10. Provide a quiet environment.
11. Limit visitors.